Attached is assignment due, You will be responding to post by 2 students by making a substantive contribution must be at least 1 1/2-2paragraphs in length with a minimum of 2 peer-reviewed references in APA Format. No Wikipedia, BLOGS with ads from or, as they present biased opinion. Use peer-reviewed articles to support your thoughts!

You will respond as if you are speaking to student, for example: Great post Cynthia, 

I like that you  mention…….i would like to add…based on your discussion…etc or you can even concur if you do not agree with everything indicated by student. 

Question by professor:

Should healthcare providers be paid (reimbursed) according to the quality of care as incentive to improve their performance (known as pay for performance)? Explain why or why not (hint:

What criteria would you use to rate their performance?

Can physicians negatively impact the CQI effects of a healthcare facility?

Student 1: Dabin Jung

I think that healthcare providers should be continued to be paid according to the quality of care to improve their performance. According to Beich, Scanlon, and Boyce (2010), both financial incentives and public recognition have been shown to be related to increased quality improvement activities among health care providers (HCP). The financial incentives are what is known as pay for performance. According to Sutton et al. (2012), the institution of pay for performance in a region of England was associated with a significantly reduced mortality rate.

The criteria I would use to rate HCP’s performance are clinical outcomes like the effectiveness of care, an average of hospital stays for patients, and the mortality rate. However, sometimes the mortality rate is not decided by the HCP’s abilities. Therefore, I would include one more criterion which is participation. There is already a similar way to motivate HCP to involve in quality improvement activities which is pay for participation (Beich, Scanlon & Boyce, 2010). In this case, HCP are reimbursed according to their time and cost of engaging in quality improvement activities (Beich, Scanlon & Boyce, 2010). Physicians can negatively impact the CQI effects of a healthcare facility in many ways. One way of negatively impacting the CQI effects of a healthcare facility is by not adhering to the recommended processes (McGlynn et al, 2003).

Beich, J., Scanlon, D. P., & Boyce, P. S. (2010). A community-level effort to motivate physician participation in the National Committee for Quality Assurance Diabetes Physician Recognition Program. Population Health Management.13(3).

Glynn, E. A., Asch, S. M., Adams, J., Keesey, J., Hicks, J., DeCristofaro, A., & Kerr, E. A. (2003). The quality of health care delivered to adults in the United States. The New England journal of medicine, 348(26), 2635–2645.

Sutton, M., Nikolova, S., Boaden, R., Lester, H., McDonald, R., & Roland, M. (2012). Reduced mortality with hospital pay for performance in England. New England Journal of Medicine, 367(19), 1821–1828.

Student 2: Cheryl Brockhouse 

Top of Form

I feel that health care providers should be paid according to the care that they give. It is commonly accepted that payment methods influe

Username: [email protected]

Password: 547GorgeRd

Finding Academic Scholarly Articles

Academic literature is very important to your graduate work. You will want to limit the use of the Web, and instead increase the use of scholarly literature. Note: Wikipedia is not an acceptable source for graduate-level work.

All of your opinions should be backed-up with academic scholarly peer reviewed articles whether they be in discussions or in papers. Your textbook alone as a source is never enough.

To find this academic literature all you need to do is go to your online library. The link and instructions on how to log in are located under Course Home. I would suggest you begin with ProQuest database at the LIRN area of the online library. Within the ProQuest database you will want to be sure that you check the two boxes at the bottom of your keyword search: you want to check full text and you want to check the box for scholarly peer-reviewed work (these are academic). On the ProQuest site you’ll see a little graduation tassel to indicate this will render academic scholarly journals and literature.

ProQuest says of academic articles:

“Scholarly Journals, including peer-reviewed

A publication is considered to be scholarly if it is authored by academics for a target audience that is mainly academic, the printed format isn’t usually a glossy magazine, and it is published by a recognized society with academic goals and missions.

A publication is considered to be peer reviewed if its articles go through an official editorial process that involves review and approval by the author’s peers (people who are experts in the same subject area.) Most (but not all) scholarly publications are peer reviewed. Some trade publications are actually peer reviewed, but ProQuest does not consider them when filtering on peer reviewed. This is because getting results from trade publications instead of academic journals can be frustrating to researchers. Instead, ProQuest excludes these peer reviewed trade publications and only considers publications that are scholarly in terms of content, intent, and audience.”

Enjoy exploring the library. It is one of the great joys of academic research!

Chapter 1: The Global Evolution of Continuous Quality Improvement: From Japanese Manufacturing to Global Health Services




Characteristics / Elements of CQI

Evolution of CQI in Health Care

Broad-Based Approaches to CQI


Continuous quality improvement (CQI) has evolved over time and across countries

Substantial progress has been made in the diffusion of CQI in health, e.g., in public heath

The need for greater diffusion of CQI continues, particularly due to greater complexity in health care systems

Quality and safety problems persist in health care and new techniques are available to address these

Definition of Quality in Health

The WHO definition of quality of care is “the extent to which health care services provided to individuals and patient populations improve desired health outcomes. In order to achieve this, health care must be safe, effective, timely, efficient, equitable and people-centered.”

Components of Health (WHO)

Safe. Delivering health care that minimizes risks and harm to service users, including avoiding preventable injuries and reducing medical errors.

Effective. Providing services based on scientific knowledge and evidence-based guidelines.

Timely. Reducing delays in providing and receiving health care.

Efficient. Delivering health care in a manner that maximizes resource use and avoids waste.

Equitable. Delivering health care that does not differ in quality according to personal characteristics such as gender, race, ethnicity, geographical location or socioeconomic status.

People-centered. Providing care that takes into account the preferences and aspirations of individual service users and the culture of their community

Quality Assurance(QA)

QA focuses on conformance quality, which is defined as “conforming to specifications; having a product or service that meets predefined standards” (McLaughlin & Kaluzny, 2006, p. 37).

QA is sometimes the primary goal of accreditation processes.

Definition of CQI in Health Care

CQI is defined as a structured organizational process for involving personnel in planning and executing a continuous flow of improvements to provide quality health care that meets or exceeds expectations

Common Characteristics of CQI

• a link to key elements of the organization’s strategic plan;

• a quality council made up of the institution’s top leadership;

• training programs for personnel;

• mechanisms for selecting improvement opportunities;

formation of process improvement teams;

• staff support for process analysis and redesign;

Chapter 2: Factors Influencing the Application and Diffusion of CQI in Health Care



The dynamic character of CQI

The current state of CQI in healthcare

CQI and the science of innovation

The business case for CQI

Factors affecting successful CQI application

Motivational factors

The quadruple aim

Culture of excellence


CQI is utilized across health care sectors (including primary and preventative care) as well as across geographic and economic boundaries

The need for CQI is increasing

One reason: the safety and quality of care has shown improvement since 2000 but further improvement is needed and improvement should be part of everyone’s goal in health care: clinicians, managers, researchers, and patients and their families

Greater complexity and new technology

External forces are increasing the demand for higher quality

Accreditation, legislation(e.g. the ACA in the U.S)


Despite the continuing evolution and spread of CQI in health care in the 21st century

Some important questions remain about the adaptation and diffusion of quality improvement methods, especially in regard to the central role of individual health care providers. These include questions such as:

Why aren’t more health care providers using CQI tools and processes?

Why is the gap between knowledge and practice so large?

Why don’t clinical systems incorporate the findings of clinical science or copy the “best known” practices reliably, quickly, and even gratefully into their daily work simply as a matter of course?

How to expand further the implementation of CQI in health care?

This lecture will review a number of factors and processes have been shown to facilitate or impede the implementation of CQI in health care

The Dynamic Character of CQI

CQI methodology is constantly being refined and tested: it is an evolutionary quality improvement mechanism

This is because in response to new challenges, CQI applications develop via continuous, ongoing learning and sharing among disciplines about ways to use CQI philosophies, processes and tools in a variety of settings

Discussion Questions

What is the current state of quality in health care?

What are the problems regarding implementation of CQI in health care?

Given the widespread application of CQI, what factors that contribute to the implementation of CQI across industries and settings?

What are the factors that have influenced the rate of diffusion and spread of CQI in health care?

The Current State of CQI in Healthcare

• A decade after the Inst